| Specialty
Groups — Oncology
Medical Oncology Code Changes
ACOA Coding Minute
There
are a number of myths regarding the coding and billing of block
verification simulations, and it is important to note that the medical
record should include the following when this service is billed:
- An
order from the radiation oncologist for a verification simulation. The
radiation oncologist is responsible for determining the procedures
necessary for patient treatment, and it is essential that both
professional and facility billing reflect the type and level of service
performed. It is not appropriate for the facility to bill the initial set
of port films as a verification simulation without a physician order for
this service.
-
The
medical necessity for a verification simulation should be documented in
the medical record. Most payors indicate that an initial set of port films
are necessary to ensure that all treatment devices are in place, patient
positioning is correct, etc. If a verification simulation is needed in
place of port films, the medical indication for this service should be
included in the medical record.
-
The
verification simulation should be documented with a simulation note in the
same manner as any other simulation service.
Providing
that information in the patient medical record supports the need for, and
performance of, a verification simulation, there should be no difficulty
receiving reimbursement for this service.
Cindy
C. Parman, CPC, CPC-H
principal and co-founder of Coding Strategies, Inc. in Atlanta, GA. Cindy
is a current member of the Advisory Board for the American Academy of
Professional Coders (AAPC) and a faculty instructor for AMA Solutions, a
subsidiary of the American Medical Association. She serves as the Consulting
Editor of the Radiology Coding Alert
and is on the Editorial Advisory Board of General Surgery Coding Alert and Pain Management Coding Alert.
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